Head & neck · 2026
Clinicoepidemiologic Profile of Oral Kaposi Sarcoma in People Living With HIV: A Systematic Review and Meta-Analysis.
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Otávio Ericles, Badaró Rebeca Ferreira, Rodrigues Daniel Pignatari Mahet, Silva Giselle de Medeiros, de Arruda José Alcides Almeida, Drumond Victor Zanetti, Tenório Jefferson R, Jural Lucas Alves, Magno Marcela Baraúna, Maia Lucianne Cople, de Andrade Bruno Augusto Benevenuto
Аннотация
BACKGROUND: To characterize the clinicoepidemiologic profile of HIV-associated oral Kaposi sarcoma (OKS) and quantitatively synthesize its frequency, anatomical distribution, and temporal patterns across antiretroviral therapy (ART) eras.
METHODS: Six databases and gray literature were searched. Eligible observational, descriptive, and quasi-experimental studies were appraised using JBI tools. Random-effects meta-analyses of patient-based proportions and treatment-era subgroup were performed when compatible study-level denominators were available (PROSPERO: CRD420251105061).
RESULTS: Forty-eight studies comprising 1661 individuals were included, and 31 contributed to at least one meta-analysis. Pooled proportions were 0.85 (95% CI: 0.76-0.91) for palatal involvement and 0.44 (95% CI: 0.23-0.68) for OKS as a sentinel presentation of HIV. Pooled prevalence of OKS among people living with HIV was 0.06 (95% CI: 0.02-0.12). Compared with the pre-combination ART era, the combination ART era showed lower palatal (0.72 vs. 0.89; p = 0.0034) and gingival involvement (0.07 vs. 0.30; p = 0.0003), but more sentinel presentations (0.72 vs. 0.32; p = 0.0195). Methodological quality was moderate, with substantial heterogeneity.
CONCLUSIONS: Pooled evidence confirms strong palatal predilection of HIV-associated OKS. Temporal subgroup findings suggest changes in oral distribution across ART eras while reinforcing its persistent role as a sentinel manifestation of HIV infection and persistent clinical relevance despite ART.
METHODS: Six databases and gray literature were searched. Eligible observational, descriptive, and quasi-experimental studies were appraised using JBI tools. Random-effects meta-analyses of patient-based proportions and treatment-era subgroup were performed when compatible study-level denominators were available (PROSPERO: CRD420251105061).
RESULTS: Forty-eight studies comprising 1661 individuals were included, and 31 contributed to at least one meta-analysis. Pooled proportions were 0.85 (95% CI: 0.76-0.91) for palatal involvement and 0.44 (95% CI: 0.23-0.68) for OKS as a sentinel presentation of HIV. Pooled prevalence of OKS among people living with HIV was 0.06 (95% CI: 0.02-0.12). Compared with the pre-combination ART era, the combination ART era showed lower palatal (0.72 vs. 0.89; p = 0.0034) and gingival involvement (0.07 vs. 0.30; p = 0.0003), but more sentinel presentations (0.72 vs. 0.32; p = 0.0195). Methodological quality was moderate, with substantial heterogeneity.
CONCLUSIONS: Pooled evidence confirms strong palatal predilection of HIV-associated OKS. Temporal subgroup findings suggest changes in oral distribution across ART eras while reinforcing its persistent role as a sentinel manifestation of HIV infection and persistent clinical relevance despite ART.